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HPV vaccination leads to rapid decline in genital warts, Australia.

The number of young women presenting with new cases of genital warts in Australia has declined since the introduction of the national human papillomavirus vaccination programme. A retrospective study examined the proportion of new patients with genital warts attending Melbourne Sexual Health Centre from January 2004 to December 2008. Australia has offered the quadrivalent HPV vaccine, Gardasil, free to 12-18 year old girls in schools since April 2007, and to women aged 26 and younger in general practices since July 2007. Take-up rates have been approximately 70%. Gardasil targets HPV types 6, 11, 16, and 18. Types 6 and 11 are associated with genital warts, and types 16 and 18 with the development of cervical cancer. A total of 36,055 new patients attended the clinic and genital warts were diagnosed in 3,826 (10.6%). The proportion of women under 28 years diagnosed with warts decreased by 25.1% each quarter in 2008, which was significantly different from the 1.8% increase per quarter from 2004 to 2007 (p<0.001). Women under 28 made up about 13% of patients diagnosed as having genital warts before 2008, but only 6.6% in 2008. The only other group that saw a decline in genital warts was heterosexual men, among whom new diagnoses fell by 5% each quarter in 2008 (p=0.031). The data suggest that a rapid and marked reduction in genital wart incidence may be achievable through an HPV vaccination programme targeting adolescents and young women, and supports some benefit being conferred on heterosexual men. These results are important for countries deciding between the bivalent vaccine that does not protect against warts and the quadrivalent vaccine. (1,2)

(1.) Fairley CK, Hocking JS, Gurrin LC, et al. Rapid decline in presentations of genital warts after the implementation of a national quadrivalent human papillomavirus vaccination programme for young women. Sexually Transmitted Infections 2009;85:499-502.

(2.) Kmietowicz Z. Australian cervical cancer vaccination leads to rapid decline in genital warts. BMJ 2009; 339:b2421.

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Title Annotation:ROUND UP: Service delivery; human papillomavirus
Publication:Reproductive Health Matters
Geographic Code:8AUST
Date:May 1, 2010
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